Why Does My Elbow Hurt From My Tennis or Golf Swing?

Your elbow started aching a few rounds or matches ago — and now it flares every time you grip, swing, or shake someone's hand. You've heard the terms "tennis elbow" and "golfer's elbow" thrown around, probably assumed one of them applies, and started looking for exercises.

Problem is, these are two different conditions on two different sides of the elbow, and the wrong treatment for the wrong one won't do much.

The good news: once you know which side of the elbow hurts and what it means, the rest of the picture falls into place quickly.

Tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis) are tendon-related conditions on opposite sides of the elbow. Tennis elbow affects the tendons on the outer (lateral) side, primarily the wrist extensors, and hurts with gripping, twisting, and backhand motions. Golfer's elbow affects the tendons on the inner (medial) side, primarily the wrist flexors, and hurts with gripping, lifting, and forehand or throwing motions. Despite their names, either can develop from any repetitive gripping activity — not just tennis or golf.

Here's how to tell which one you have and why they need different approaches.

Why Does My Elbow Hurt From My Tennis or Golf Swing?:

Tennis Elbow: Pain on the Outer Side

Tennis elbow involves the common extensor tendon on the lateral (outer) side of the elbow — where the muscles that extend your wrist and fingers attach to the bony point you can feel on the outside of your elbow.

Pain is typically sharpest right at that bony point, though it can radiate down into the forearm. It's reproduced by gripping, wrist extension against resistance, and motions that stress the backhand side of a tennis stroke — but it just as commonly develops from repeated use of a screwdriver, heavy mouse use, or anything involving sustained gripping with the wrist in extension.

Despite being called "tendinitis" for decades, research examining the actual tissue has found that tennis elbow is more accurately described as a tendinopathy — a degenerative process rather than a purely inflammatory one — which partly explains why anti-inflammatory approaches alone often provide temporary relief but don't resolve it long-term.

Golfer's Elbow: Pain on the Inner Side

Golfer's elbow involves the common flexor tendon on the medial (inner) side of the elbow — where the muscles that flex your wrist and fingers attach to the bony point on the inside.

Pain sits right at that inner bony point and may radiate into the forearm. It's reproduced by gripping, wrist flexion against resistance, and motions that stress the forehand or throwing side — the follow-through of a golf swing, a forehand in tennis, or a throwing motion.

Like tennis elbow, it develops from any repetitive gripping or forearm activity, not exclusively golf. And like tennis elbow, the underlying tissue change is primarily degenerative rather than inflammatory.

Why These Are Different Problems Despite Both Being "Elbow Pain"

The tendons involved are on opposite sides of the elbow, controlling opposite movements. Tennis elbow tendons extend (pull back) the wrist. Golfer's elbow tendons flex (curl forward) the wrist. This means:

Different activities provoke each one. The specific swing mechanics that stress one condition are different from those that stress the other — a backhand tennis stroke loads the lateral side, while a golf follow-through or forehand loads the medial side.

Different strengthening approaches address each one. Tendon loading programs for tennis elbow target wrist extensors specifically. Programs for golfer's elbow target wrist flexors. Strengthening the wrong side doesn't address the problem.

Location is the simplest differentiator. If you press on the bony bump on the outside of your elbow and that's the tender spot, it's tennis elbow. If the bony bump on the inside is the tender spot, it's golfer's elbow. This takes about five seconds to check.

What Actually Causes These in Racquet and Club Sports

In tennis or pickleball, the backhand stroke places significant eccentric load on the wrist extensors — they're working hard to stabilize the wrist against the force of the ball impact. Poor technique, a grip that's too tight, a racquet that's too heavy or strung too tightly, or simply playing more than the tendons are conditioned for can all contribute.

In golf, the trailing arm during the swing's follow-through loads the medial forearm flexors, and the lead arm loads the lateral extensors — which is why both tennis elbow and golfer's elbow can develop from golf specifically, depending on which arm is affected and what phase of the swing is producing the most stress.

What Treatment Looks Like

For both conditions, the evidence-based approach centers on progressive tendon loading — specifically eccentric and isometric exercises targeting the affected tendons, gradually rebuilding their capacity to handle the forces your sport demands.

For tennis elbow: wrist extensor eccentric loading, grip strength development, and addressing any technique or equipment factors on the lateral side.

For golfer's elbow: wrist flexor eccentric loading, forearm strengthening, and addressing technique or equipment factors on the medial side.

Both benefit from activity modification during the acute phase (reducing the specific provoking volume, not necessarily stopping all activity), manual therapy addressing any secondary muscle tightness that's developed, and a progressive return to full play as tendon capacity rebuilds.

Most people notice meaningful improvement within several weeks of consistent, appropriately loaded exercise. Many feel a difference within the first few visits once the right tendon loading program is in place.

When It's Worth Getting This Looked At

Worth scheduling an evaluation if: elbow pain is affecting your grip, your game, or your daily function, you've tried rest without lasting improvement, you're not sure which side of the elbow is actually the problem, or pain has been present for more than a few weeks.

Common Questions About Tennis Elbow and Golfer's Elbow

Can I have both at the same time?

It's uncommon but possible, particularly in sports or occupations involving heavy, repetitive gripping from multiple angles.

Do I need to stop playing my sport during treatment?

Not necessarily — modifying volume, technique, and equipment is often sufficient. Complete rest from the sport is generally less effective long-term than progressive loading alongside modified play.

Will a brace or strap help?

A counterforce brace can reduce tendon stress during activity and is a reasonable short-term tool, but it's supplementary to tendon loading and strengthening, not a substitute for it.

Why hasn't rest fixed this?

Because the underlying tissue change is degenerative rather than purely inflammatory — tendons that have degenerated need progressive loading to remodel, not just time off. Rest alone often leads to temporary relief followed by return of symptoms once activity resumes.

Could this be a nerve problem instead?

It's possible — nerve entrapment at the elbow can produce symptoms in a similar location. Assessment differentiates tendon-based pain from nerve-based symptoms, which typically include numbness, tingling, or a different quality of pain.

How long does this typically take to resolve?

Most people see meaningful improvement within 4-8 weeks of consistent tendon loading exercise, with continued progress as capacity builds. Longer-standing cases sometimes take longer.

Does technique correction matter, or is it purely a tendon problem?

Both matter. Tendon loading rebuilds capacity, but if the technique or equipment factor that created the overload isn't addressed, the tendon is likely to become overloaded again.

Is surgery ever necessary?

Rarely, and only after a genuine, sustained trial of conservative treatment hasn't produced improvement — which resolves the large majority of cases.

Why Does My Elbow Hurt From My Tennis or Golf Swing?: Bottom Line

Tennis elbow and golfer's elbow are opposite-side tendon conditions that look similar on the surface but involve different tendons, different movements, and different treatment emphasis. The simplest way to tell them apart: which bony bump on your elbow is tender — outer (tennis elbow) or inner (golfer's elbow)? Getting that right determines whether your strengthening program is targeting the correct side.

Elbow pain affecting your game or your grip?

Schedule a Physical Therapy Evaluation at Nashville Physical Therapy & Performance. You'll get completely 1:1 care with your therapist for the entire visit — no aides, no split attention. We'll identify exactly which tendon is involved and build a loading program that gets you back to playing without pain. Available at East Nashville, West Nashville/The Nations, Brentwood, and our new Goodlettsville location, opening October 5 with both orthopedic and pelvic floor services. Call 615-428-9213 or book online at nashvillept.com.

References

[^1]: Lateral Epicondylitis (Tennis Elbow). StatPearls. National Center for Biotechnology Information. 2024.

[^2]: Medial Epicondylitis. StatPearls. National Center for Biotechnology Information. 2024.